| NPI | 1609260124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A191791) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A191791) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: CA A191791) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2023-12-13 |