| NPI | 1740305473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.152739) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ME 014566) |
| 207Y00000X Otolaryngology (Licence: ND 11025) | |
| 207Y00000X Otolaryngology (Licence: MN 38570) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2025-04-25 |