| NPI | 1427152503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD18593) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00031415) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2022-02-04 |