| NPI | 1821559329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 338251) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2024026116) |
| 207Y00000X Otolaryngology (Licence: KS 04-49475) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-09-12 |