| NPI | 1467404657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 55595) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 200300429) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-06-30 |