| NPI | 1619945938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: HI MD-19699) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SD 5996) |
| 207Y00000X Otolaryngology (Licence: WI 52515) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2021-07-14 |