| NPI | 1609875467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN MD0000026020) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 047438) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2021-06-11 |