| NPI | 1811016561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CO 0055033) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A125381) |
| 207Y00000X Otolaryngology (Licence: MO 2006017323) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2021-06-03 |