| NPI | 1295083558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX R3839) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD175293) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2022-07-21 |