| NPI | 1003349598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 67739) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD61288654) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA MD61288654) | |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2023-08-07 |