| NPI | 1972007433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MN 74279) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 11390599-1205) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-10-17 |