| NPI | 1083034367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AL 38093) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: AL 38093) |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2020-06-16 |