| NPI | 1174743918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 060771) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS 19375) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2025-10-13 |