| NPI | 1851315147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: NY 202629) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 202629) |
| 207Y00000X Otolaryngology (Licence: NY 202629) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-12-18 |