| NPI | 1316982515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 023370) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 64523) |
| 207Y00000X Otolaryngology (Licence: CA C158137) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2024-03-14 |