| NPI | 1497311435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ID O-1494) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ID O-1494) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2026-07-14 |