| NPI | 1821431594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A131738) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: HI MD-20512) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2026-08-20 |