| NPI | 1235199530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A85706) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A85706) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A85706) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2025-12-16 |