| NPI | 1144581059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 79106) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: HI MD17315) |
| 207Y00000X Otolaryngology (Licence: KY 60296) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2025-07-08 |