| NPI | 1891010674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CO CDRH.0056654) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO CDRH.0056654) |
| 207Y00000X Otolaryngology (Licence: CO DR.0056654) | |
| 207Y00000X Otolaryngology (Licence: CO CDRH.0056654) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CO DR.0056654) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2022-03-11 |