| NPI | 1295094548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX R0715) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX BP10043943) |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2021-08-09 |