| NPI | 1235492372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: MO 2017008331) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2017008331) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2025-08-22 |