| NPI | 1114312527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301507230) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: UT 11684791-1205) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2022-08-08 |