| NPI | 1073508016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD.017292) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 96-00594) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2021-06-24 |