| NPI | 1598887861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA OP60500221) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KS 0530995) |
| 207Y00000X Otolaryngology (Licence: NE 774) | |
| 207Y00000X Otolaryngology (Licence: AZ 005600) | |
| 207Y00000X Otolaryngology (Licence: GA 63863) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2021-06-08 |