| NPI | 1003801606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 9400559) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 94-00559) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2022-07-08 |