| NPI | 1558565127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A105171) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX BP2-0016819) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-11-29 |