| NPI | 1568433225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 40456) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 17722) |
| 207Y00000X Otolaryngology (Licence: IA 29480) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2023-07-28 |