| NPI | 1578714440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: NE 27214) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 27214) |
| 207Y00000X Otolaryngology (Licence: TX BP10032053) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2018-01-24 |