| NPI | 1598108698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 63443) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 68905) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2025-06-24 |