| NPI | 1154600922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8390890-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ID M12339) |
| 207Q00000X Family Medicine (Licence: ID M12339) | |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2021-08-10 |