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 |