| NPI | 1609286871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: TX V1514) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX V1514) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2025-02-06 |