| NPI | 1689091522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX S5306) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D87062) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2022-12-06 |