| NPI | 1487752655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MT 6361) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MT 6361) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MT 6361) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2025-10-14 |