| NPI | 1477781193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2024-02718) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A135617) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2024-11-13 |