| NPI | 1700955127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101266374) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2011-00580) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2022-08-09 |