| NPI | 1629459300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: OR MD210112) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO XXXXXXXX) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2022-08-09 |