| NPI | 1356488126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 7310292-1205) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: KY R0986) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2023-11-27 |