| NPI | 1699972018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: GA 072750) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R8157) |
| 207Y00000X Otolaryngology (Licence: MI 4301102731) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2016-07-08 |