| NPI | 1760877542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D89352) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CO DR.0076773) |
| 207Y00000X Otolaryngology (Licence: CO DR.0076773) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2026-05-15 |