| NPI | 1114154663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2021-00726) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101247938) |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2022-07-11 |