| NPI | 1083920177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: OR DO173551) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR DO173551) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2025-04-28 |