| NPI | 1568995918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A202496) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX V0759) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2025-07-28 |