| NPI | 1598298010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U6706) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 77197) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2023-09-29 |