| NPI | 1649400938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2021-02779) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 47270) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2021-09-24 |