| NPI | 1306297841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2023-00810) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 66570) |
| 207YS0012X (Licence: NC 2023-00810) | |
| 207YS0012X (Licence: TN 66570) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2024-11-15 |