| NPI | 1710074851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 87102) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN MD35159) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2022-03-25 |