| NPI | 1356464689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 50410) |
| Additional Taxonomies | 207YX0901X Otolaryngology Otology & Neurotology (Licence: VA 0101253457) |
| 207Y00000X Otolaryngology (Licence: TX N0925) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: TX N0925) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-05-07 |