| NPI | 1932738945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX W5561) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX W5561) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-09-10 |