| NPI | 1336198696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 13815) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WY 6908A) |
| 207Y00000X Otolaryngology (Licence: ND PT13815) | |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2023-04-13 |