| NPI | 1003838665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0012X (Licence: MI 4301096614) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND 9374) |
| 207Y00000X Otolaryngology (Licence: MI 4301096614) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2024-02-15 |