| NPI | 1225012610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 7806295-1205) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: UT 7806295-1205) |
| 174400000X Specialist | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2021-11-22 |