| NPI | 1649590076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 62125) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R-8875) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2025-04-25 |