| NPI | 1134486756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 66936) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA MD44414) |
| 207Y00000X Otolaryngology (Licence: KY R3537) | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2022-07-21 |