| NPI | 1972737237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX T4752) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2010019837) |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2024-11-13 |