| NPI | 1376623165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-5994) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2004014126) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AR E-5994) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2023-10-18 |