| NPI | 1568660306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX R3869) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX 45529) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2026-06-12 |