| NPI | 1417025206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MT 11225) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR MD202201) |
| 207Y00000X Otolaryngology (Licence: MT 11225) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2022-01-03 |