| NPI | 1326366279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A117462) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A117462) |
| Enumeration Date | 2010-05-16 |
| Last Update Date | 2021-11-04 |