| NPI | 1366241770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA 202845) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ZZ 121531) |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-06-25 |