| NPI | 1689823932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 61285) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 1234567) |
| 207Y00000X Otolaryngology (Licence: SC 36777) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2021-09-14 |