| NPI | 1821775701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 1023858) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY P122087) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NY P122087) | |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2025-06-19 |