| NPI | 1760503171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 82870) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MI 5101015878) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2022-09-27 |