| NPI | 1194747006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 52664) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX M3723) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2019-01-07 |