| NPI | 1891995940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN MD43601) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2003015432) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2023-06-20 |