| NPI | 1053334805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: UT 6230098-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 39476) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TN 39476) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-10-20 |