| NPI | 1700030459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2013-00091) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NC 2013-00091) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NC 2013-00091) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: NC 2013-00091) | |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2018-09-24 |