| NPI | 1881758183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: HI MD 14082) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO CDRH.0063561) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2021-07-20 |