| NPI | 1144545096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 75683) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 262561) |
| 207Y00000X Otolaryngology (Licence: VA 0101258556) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2021-06-07 |