| NPI | 1760547418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NH 11921) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 81920) |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2025-07-17 |