| NPI | 1003310855 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AR E-18135)  | 
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: AR E-18135)  | 
| 207Y00000X Otolaryngology (Licence: MO 023022999)  | |
| Enumeration Date | 2018-03-19 | 
| Last Update Date | 2024-09-17 |