| NPI | 1336132315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA L019073) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: LA L019073) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-03-16 |