| NPI | 1942644489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: DE C1-0013135) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX BP10047052) |
| 207Y00000X Otolaryngology (Licence: NY 292784) | |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2021-06-23 |