| NPI | 1528387792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NM MD2012-0168) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A102582) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IA 39357) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2023-10-26 |