| NPI | 1912935370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 108176) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 38755) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2020-11-10 |