| NPI | 1508151481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX Q6968) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC LL33725) |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2021-08-09 |