| NPI | 1497169734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 30729) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60927106) |
| Enumeration Date | 2014-06-15 |
| Last Update Date | 2020-07-09 |