| NPI | 1932174745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 56183) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 34980) |
| 207Y00000X Otolaryngology (Licence: AZ 35674) | |
| 207Y00000X Otolaryngology (Licence: MN 55814) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2022-10-17 |