| NPI | 1952546384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: CA A133118) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: CA A 133118) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2023-10-10 |