| NPI | 1649242652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35069181P) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: OH 35.069181) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2023-10-11 |