| NPI | 1770550923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD00038872) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: WA MD00038872) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2022-06-01 |