| NPI | 1194984997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MI 4301101980) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301101980) |
| 207Y00000X Otolaryngology (Licence: OH 35123377) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2023-11-20 |