| NPI | 1134863079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC MMD.92402AL) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: SC MMD.92402AL) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2024-08-15 |