| NPI | 1992382238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA DO.OP.70036793) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA DO.OP.70036793) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-08-26 |