| NPI | 1023013612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX E5858) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX E5858) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2023-03-06 |