| NPI | 1619150349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL 17340) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS 23702) |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MS 23702) | |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2024-03-25 |