| NPI | 1093158735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AZ 58528) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 58528) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2025-11-04 |