| NPI | 1275539603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 39895) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TN 01428) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2026-03-18 |