| NPI | 1013207588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0069951) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX R8456) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2023-03-01 |