| NPI | 1447220926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 008415) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS 18626) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MS 18626) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2020-10-20 |