| NPI | 1548234842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX J4559) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NM MD2020-1060) |
| 207Y00000X Otolaryngology (Licence: CO DR0048157) | |
| 207Y00000X Otolaryngology (Licence: FL ME142510) | |
| 174400000X Specialist (Licence: TX J4559) | |
| 207Y00000X Otolaryngology (Licence: AZ 63345) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2023-04-06 |