| NPI | 1366901746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.156883) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: OR MD224091) |
| 207Y00000X Otolaryngology (Licence: OR MD224091) | |
| 207Y00000X Otolaryngology (Licence: WA ML60959279) | |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2026-08-06 |