| NPI | 1467914341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY TP628) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 70616) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-08-23 |