| NPI | 1871099499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TN 71712) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 89309) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2024-09-23 |