| NPI | 1023334919 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MI 4301503576) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301503576) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2020-12-10 |