| NPI | 1720285166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 072220) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC LL29789) |
| 208600000X Surgery (Licence: SC LL29789) | |
| 208600000X Surgery (Licence: GA 072220) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2023-03-07 |