| NPI | 1548323777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 112260) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35-065655) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2022-09-02 |