| NPI | 1407968142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 62295-20) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 36244) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-02-24 |