| NPI | 1356906697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: SC MD95221) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC MD95221) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2025-08-14 |