| NPI | 1326242975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: TN 48365) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 48365) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-06-27 |