| NPI | 1679747307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A109191) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IN 01064955A) |
| Enumeration Date | 2008-04-14 |
| Last Update Date | 2024-09-26 |