| NPI | 1801054176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2009-00621) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2008005694) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2021-03-31 |