| NPI | 1447756069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 13827321-8905) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A163955) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-06-28 |