| NPI | 1275513269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX K9046) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K9046) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL OS14610) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2023-03-14 |