| NPI | 1386136174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U3479) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX U3479) |
| 207Y00000X Otolaryngology (Licence: TX BP10063418) | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2023-07-28 |