| NPI | 1689883449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 249646) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: NY 249646) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2022-07-20 |