| NPI | 1790276244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: NY 337458) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MI 4301509593) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2025-06-20 |