| NPI | 1306804869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 38757) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 38757) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-01-30 |