| NPI | 1376648378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 49144) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 53183) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2025-12-19 |