| NPI | 1790747889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: VA 010-1026376) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: ND PT22030) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: VA 010-1026376) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: VA 010-1026376) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2025-01-09 |