| NPI | 1255524328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 50623) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CT 050623) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CT 050623) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2018-03-27 |