| NPI | 1144718701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301512429) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 81596) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WI 81596-20) | |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2024-07-15 |