| NPI | 1265457287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TN 64093) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 64093) |
| 207Y00000X Otolaryngology (Licence: CA C136361) | |
| 207Y00000X Otolaryngology (Licence: AL 24189) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-03-31 |