| NPI | 1932136173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SD 5042) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 22982) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-07-06 |