| NPI | 1871521567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX J7153) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 101249) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2024-08-14 |