| NPI | 1538696091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX T8178) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC LL40869) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2022-08-08 |