| NPI | 1104357425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 70160) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: WI 70160) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-09-01 |