| NPI | 1033436423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2016-00549) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD170496) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: OR MD170496) | |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2016-12-02 |