| NPI | 1255569570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL OS12619) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA OT013216) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2024-05-14 |