| NPI | 1013200740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 277943) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NH 23906) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2023-05-01 |