| NPI | 1336370121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 30125) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2023033294) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2023-10-11 |