| NPI | 1336340009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 67066) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 44782) |
| 207Y00000X Otolaryngology (Licence: MO 2006023188) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-12-03 |