| NPI | 1093752719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 66483) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME 98348) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: GA 66483) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2025-07-30 |