| NPI | 1033775523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD225039) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 1019362) |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2025-09-03 |