| NPI | 1952345811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G44732) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G44732) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA G44732) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2022-07-29 |