| NPI | 1285056903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: TX R2080) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A128403) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2023-08-28 |