| NPI | 1124434071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A139760) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60934004) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2025-03-03 |