| NPI | 1699067751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0901X Otolaryngology, Otology & Neurotology (Licence: MI 5101019136) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA OP60635271) |
| 207Y00000X Otolaryngology (Licence: MI 5101019136) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MI 5101019136) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2022-12-27 |