| NPI | 1467446799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NE 11860) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 11860) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2022-01-18 |