| NPI | 1669908463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A191090) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX T6054) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: AZ 59340) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-09-27 |