| NPI | 1013959287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX L5799) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX L5799) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TX L5799) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-03-07 |