| NPI | 1447945118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-19950) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A200675) |
| 207Y00000X Otolaryngology (Licence: FL ME176119) | |
| 207Y00000X Otolaryngology (Licence: PR 24730) | |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2025-11-07 |