| NPI | 1467418582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101234824) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NM MD2010-0117) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2021-04-01 |