| NPI | 1609848076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA a95370) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 35464) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2021-11-22 |