| NPI | 1659900454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: CO DR.0076983) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX V6407) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2026-06-24 |