| NPI | 1497768881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C177627) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO 51198) |
| 207Y00000X Otolaryngology (Licence: TX N7781) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2023-02-07 |