| NPI | 1316236565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A156753) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX Q7945) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2020-08-30 |