| NPI | 1649619339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A158415) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-9831) |
| 207Y00000X Otolaryngology (Licence: IA MD-45195) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2023-11-27 |