| NPI | 1487663944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 20291) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 79762) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: PA MD459310) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2024-04-22 |