| NPI | 1730184714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 37858) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 112829) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2026-03-24 |