| NPI | 1508846460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 29426) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: KY 29714) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: SC 29426) | |
| 207Y00000X Otolaryngology (Licence: KY 29714) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2022-03-08 |