| NPI | 1689887986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 53944-020) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WI 53944-020) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-02-02 |