| NPI | 1366898322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0074665) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D87794) |
| 207Y00000X Otolaryngology (Licence: TN 70528) | |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2025-08-06 |