| NPI | 1366694218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 37437) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: SC 37437) |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2022-02-17 |