| NPI | 1679726939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX Q2705) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX BP10030820) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2020-11-27 |