| NPI | 1326530866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MI 4301511303) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 35.147752) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2024-05-03 |