| NPI | 1073500336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MT 7778) |
| Additional Taxonomies | 174400000X Specialist (Licence: MT 7778) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2024-01-08 |