| NPI | 1073771085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MA 257846) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 257846) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2023-11-08 |