| NPI | 1609951383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX M6923) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00043509) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-10-21 |