| NPI | 1346299633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 32099) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 235040) | 
| Enumeration Date | 2006-05-06 | 
| Last Update Date | 2024-08-09 |