| NPI | 1386633824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ID M-6075) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD154152) |
| 207Y00000X Otolaryngology (Licence: AK 5874) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2021-07-19 |