| NPI | 1841784097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MN 76730) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2018019754) |
| 207Y00000X Otolaryngology (Licence: TN 67744) | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2024-09-12 |