| NPI | 1831304088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: KY 43767) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME104223) |
| 207Y00000X Otolaryngology (Licence: KY TP352) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2023-09-07 |