| NPI | 1720029747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 14112) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: SC 14112) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2026-08-12 |