| NPI | 1154378065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 44185) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CT 44185) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2026-01-25 |