| NPI | 1134195894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD16303) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60415836) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2021-11-11 |