| NPI | 1023368503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: OR MD218363) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A185473) |
| 207Y00000X Otolaryngology (Licence: TX BP10065145) | |
| 207Y00000X Otolaryngology (Licence: CA A185473) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2024-08-01 |