| NPI | 1437507167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U7453) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX U7453) |
| 207Y00000X Otolaryngology (Licence: PA MT211675) | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2025-05-13 |