| NPI | 1609867266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT FP5290337) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: VA 0101051964) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2021-11-12 |