| NPI | 1790824605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-5863) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO R8E81) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2026-01-16 |