| NPI | 1922033059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA L015594) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO 47219) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-06-12 |