| NPI | 1831695568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 323238) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD61424921) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2024-02-23 |