| NPI | 1609370683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX BP10075373) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OK K083860358) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2024-04-29 |