| NPI | 1609971605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2012-01668) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH 1576) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-09-09 |