| NPI | 1457707234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX U5751) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 219179) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX U5751) | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2023-09-26 |