| NPI | 1184650285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 025898) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: CT 025898) |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: CT 025898) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: CT 025898) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2018-02-22 |