| NPI | 1508837535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX W0427) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 81135) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: KY C3344) | |
| 207Y00000X Otolaryngology (Licence: GA 97589) | |
| 207Y00000X Otolaryngology (Licence: TN 34923) | |
| 207Y00000X Otolaryngology (Licence: KY C3344) | |
| 207Y00000X Otolaryngology (Licence: CA A064209) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2025-11-20 |