| NPI | 1154520757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MO 2005019100) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MO 2009032385) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MO 2009032385) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2025-07-08 |