| NPI | 1770577090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL OS9765) |
| Additional Taxonomies | 207YS0012X (Licence: FL OS9765) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL OS9765) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: FL OS9765) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL OS9765) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MI 5101014778) | |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2023-04-22 |