| NPI | 1366443509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 104310) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 200100352) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2020-10-25 |