| NPI | 1255697975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0901X Otolaryngology Otology & Neurotology (Licence: TN 62735) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: TN 62735) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2023-12-09 |