| NPI | 1205120383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 59188) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX 28474) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2020-12-15 |