| NPI | 1598196594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: GA 80184) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 080184) |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2022-06-08 |