| NPI | 1356857528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CO DR.0077426) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO DR.0077426) |
| 207Y00000X Otolaryngology (Licence: TN 73673) | |
| 207Y00000X Otolaryngology (Licence: CA 188879) | |
| Enumeration Date | 2017-12-23 |
| Last Update Date | 2026-09-01 |