| NPI | 1528071826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX M8041) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301088425) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2022-07-11 |