| NPI | 1578747390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 21438) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA MD.201055) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2020-07-20 |