| NPI | 1588753719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 15766) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA GA015766) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2023-04-20 |