| NPI | 1609099605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 26967) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD036462) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-06 |