| NPI | 1821309683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2014-02050) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN#14893) |
| Enumeration Date | 2010-06-27 |
| Last Update Date | 2020-05-26 |