| NPI | 1740677095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A171120) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A171120) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2023-05-24 |