| NPI | 1174713994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 03299) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: KY 03299) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2022-07-20 |