| NPI | 1376525527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N5629) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: TX N5629) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2020-05-21 |