| NPI | 1346508421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: FL OS19621) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: NY 300797) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2024-09-15 |