| NPI | 1679761043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A94938) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A94938) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: CA A94938) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2023-10-16 |