| NPI | 1164411963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AL MD.37387) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN MD31430) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2020-02-26 |