| NPI | 1821048091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ID M-11713) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A70221) |
| 207Y00000X Otolaryngology (Licence: WA 60132112) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-02-03 |