| NPI | 1740329671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MO 2006003278) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2006003278) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-05-06 |