| NPI | 1588849319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2010-01971) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 129181) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2020-01-08 |