| NPI | 1427086966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 1021583) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CT 042305) |
| 207Y00000X Otolaryngology (Licence: RI MD12292) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2025-12-17 |