| NPI | 1811331721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CO DR.0062263) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CO DR.0062263) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2020-09-11 |