| NPI | 1619101334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: DC MD 037871) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: DC MD 037871) |
| 207Y00000X Otolaryngology (Licence: VA 0101245097) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: VA 0101245097) | |
| Enumeration Date | 2009-05-09 |
| Last Update Date | 2019-04-10 |