| NPI | 1831455328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A126429) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD181722) |
| 207Y00000X Otolaryngology (Licence: CO 0060269) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2022-07-21 |