| NPI | 1811359235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: TX U3922) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX U3922) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2024-08-03 |