| NPI | 1821118837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 249477) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MA 249477) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MA 249477) | |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2021-04-06 |