| NPI | 1003807124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G194687) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MA 47044) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2025-04-24 |