| NPI | 1457388316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 200700368) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN MD40839) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2021-04-23 |