| NPI | 1194889642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX E5815) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX E5815) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2026-07-21 |