| NPI | 1942247085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WV 29404) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 200500226) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2022-04-18 |