| NPI | 1245506716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C189922) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA C189922) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA C189922) | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2023-09-12 |