| NPI | 1013988948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 17417) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101281402) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2024-07-24 |