| NPI | 1477686830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 50467) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WI 50467-20) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2021-01-27 |