| NPI | 1710983267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 31995) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 319958) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2022-11-29 |