| NPI | 1679651624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 22395) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: KY 22395) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: KY 22395) | |
| 207YX0901X Otolaryngology Otology & Neurotology (Licence: KY 22395) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-10-13 |