| NPI | 1558315739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX J5638) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J5638) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX J5638) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2015-07-31 |