| NPI | 1255969887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2025-00684) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NC 2025-00684) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2026-07-17 |