| NPI | 1881672285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX L1270) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TX L1270) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX L1270) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2020-11-03 |