| NPI | 1801878905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 30184) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX J3308) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2023-03-01 |