| NPI | 1629282371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2009-00513) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 40706) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2021-04-26 |