| NPI | 1194983684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U6029) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 42184) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2023-08-31 |