| NPI | 1821223413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: DE C20010095) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NJ as2593778e50) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2021-03-17 |