| NPI | 1487874244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: GA 072072) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD448787) |
| 207Y00000X Otolaryngology (Licence: GA 072072) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2022-05-02 |