| NPI | 1841403482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN MD47559) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: OR md152269) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2022-03-28 |