| NPI | 1437156577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101240579) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 73576) |
| 207Y00000X Otolaryngology (Licence: TN 35087) | |
| 207Y00000X Otolaryngology (Licence: KY 35273) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2022-08-08 |