| NPI | 1619988243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 15739) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN MD0000030098) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2022-02-08 |