| NPI | 1467425546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: DC MD21258) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D47278) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2025-06-26 |