| NPI | 1720284508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 12428) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN 11700) |
| 207Y00000X Otolaryngology (Licence: ND PT12428) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2023-12-27 |