| NPI | 1760459283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 84833) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60116004) |
| 207Y00000X Otolaryngology (Licence: AZ 35757) | |
| 207Y00000X Otolaryngology (Licence: TN MD0000037676) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2025-01-08 |