| NPI | 1699036020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX 48282) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2017-00480) |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2025-02-14 |