| NPI | 1255795084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A200098) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX T2111) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2025-04-14 |