| NPI | 1902888217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL OS7178) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL OS7178) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2022-06-15 |