| NPI | 1003996190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C30402) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA 000000C30402) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2025-06-26 |