| NPI | 1912126723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: LA 203549) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MS 19349) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: AL 29261) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2021-02-26 |