| NPI | 1548720386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VT 042.0018598) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: VT 042.0018598) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-09-04 |