| NPI | 1538622568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX V7964) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 194645) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2025-05-15 |