| NPI | 1205924008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 75440) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX F2040) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-07-01 |