| NPI | 1083665145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD00038278) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00038278) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WA MD00038278) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2025-03-10 |