| NPI | 1770022774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 31082) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 60312) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2025-02-19 |