| NPI | 1831403237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 68624) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 267026) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2025-04-25 |