| NPI | 1235246703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR md21440) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00036967) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2022-02-04 |