| NPI | 1467451880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G71049) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: HI MD-6087) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-08-15 |