| NPI | 1043552508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A162321) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A162321) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2019-07-22 |