| NPI | 1154329894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX E1918) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY C2619) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2024-06-27 |