| NPI | 1548235393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD19567) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60381043) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2023-12-05 |