| NPI | 1043396559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A86814) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX S8419) |
| 207Y00000X Otolaryngology (Licence: MI 4301501683) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A86814) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2022-08-18 |