| NPI | 1770608580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 15518) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA C34964) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NV 15518) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2023-12-13 |