| NPI | 1023539426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 35787) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX BP10061764) |
| 207Y00000X Otolaryngology (Licence: NC 2022-00841) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2023-07-06 |