| NPI | 1477737914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD.203370) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA PGY.1.TUL-OTO) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2025-05-29 |