| NPI | 1831162601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 46856) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 73030-20) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2025-06-24 |