| NPI | 1427611300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA OP61528708) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA OP61528708) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2024-07-31 |