| NPI | 1093700387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX H2205) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX H2205) |
| 207Y00000X Otolaryngology (Licence: TX H2205) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2018-12-07 |