| NPI | 1003347204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A158313) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX T5333) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2024-02-02 |