| NPI | 1225597313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A180604) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.150678) |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2025-08-06 |