| NPI | 1134139595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2024-02028) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD60909611) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD60909611) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2024-10-11 |