| NPI | 1346484318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX Q5595) |
| Additional Taxonomies | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: CA A131477) |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: TX Q5595) | |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2020-02-03 |