| NPI | 1902801988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX J0379) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX J0379) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: TX J0379) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2026-02-11 |