| NPI | 1194787937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA 22346) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 02876) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MO 2012001378) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AZ 008057) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2025-04-11 |