| NPI | 1154671089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A131058) |
| Additional Taxonomies | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: AZ 57999) |
| 207Y00000X Otolaryngology (Licence: MA 273495) | |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2025-10-24 |