| NPI | 1841451556 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A109144)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD434096)  | 
| Enumeration Date | 2008-06-24 | 
| Last Update Date | 2024-04-29 |