| NPI | 1922001213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA 14317R) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 14317R) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2019-10-30 |