| NPI | 1093394173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MT MED-PHYS-LIC-174883) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NV 29717) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2026-08-13 |