| NPI | 1003881558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX H1081) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND 17541) |
| 207Y00000X Otolaryngology (Licence: ND PT17541) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2023-04-13 |