| NPI | 1770505984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX M2695) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX M2695) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-11-30 |