| NPI | 1194921205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A133557) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA BB5204071-AT61) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CA A133557) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2026-06-22 |