| NPI | 1275633851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MT 10286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G66522) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2021-10-19 |