| NPI | 1508083692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 50469-20) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 056445) |
| 207Y00000X Otolaryngology (Licence: KY R0595) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2024-04-10 |