| NPI | 1053308288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 9700217) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NC 9700217) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2021-04-30 |