| NPI | 1841468063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A94766) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX N2575) |
| 207Y00000X Otolaryngology (Licence: AZ 43671) | |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2022-03-25 |