| NPI | 1447457825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 22083) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WV 22083) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-04-05 |