| NPI | 1295962868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 80045) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 072001) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2026-03-05 |