| NPI | 1699879874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX M6917) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO T2003013847) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2021-07-13 |