| NPI | 1528238805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD61656857) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR 29320) |
| 207Y00000X Otolaryngology (Licence: WA MD61656857) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2025-05-01 |