| NPI | 1558568857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D86276) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301090482) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2025-12-16 |