| NPI | 1407435910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A206782) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 288574) |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2026-07-01 |