| NPI | 1407077712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA 00038886) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD22421) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-06-23 |