| NPI | 1508284209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 96793) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AR E12339) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2026-01-20 |