| NPI | 1891173753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 310366) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD61031469) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2021-12-22 |