| NPI | 1821146242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 264339-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WY 5387A) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2016-08-18 |