| NPI | 1255330650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: MO R7F68) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO R7F68) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2025-04-17 |