| NPI | 1528358017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N9261) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N9261) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2025-07-25 |