| NPI | 1700145182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: VA 0101266254) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 255486) |
| Enumeration Date | 2012-05-06 |
| Last Update Date | 2019-07-24 |