| NPI | 1053571794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2013045551) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY TP526) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2025-01-16 |