| NPI | 1992168298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 80808) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD473507) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2025-11-03 |