| NPI | 1942416714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 13161) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SD 11582) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2022-05-27 |