| NPI | 1184910614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2018-00496) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NC 2018-00496) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2026-05-22 |