| NPI | 1609057934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 326513) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS 22607) |
| 207Y00000X Otolaryngology (Licence: PA MD468919) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2021-10-26 |