| NPI | 1336646066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61421136) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA MD61421136) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2023-07-31 |