| NPI | 1821559840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2025-01849) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX u9322) |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2025-09-30 |