| NPI | 1285255448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61666933) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA MD61666933) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2025-08-04 |