| NPI | 1023371549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CT 60345) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CT 60345) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2018-11-06 |