| NPI | 1194823096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX Q5991) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX Q5991) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX Q5991) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2019-02-05 |