| NPI | 1982145108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101278964) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0094939) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-06-22 |