| NPI | 1841814548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA 183167) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA 183167) |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2025-06-18 |