| NPI | 1134428790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 54246) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX Q5862) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2020-09-10 |