| NPI | 1740242692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 63492) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 40043) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2025-06-02 |