| NPI | 1083119408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 77019) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D92340) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2026-06-09 |