| NPI | 1548335904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL 36001) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 21182) |
| 207Y00000X Otolaryngology (Licence: GA 040596) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-02-12 |