| NPI | 1942582929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX q7965) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX BP10039761) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2026-09-10 |