| NPI | 1336316819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2009-00715) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 110489) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2021-04-01 |