| NPI | 1952657348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: VA 0102203422) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0102203422) |
| 207Y00000X Otolaryngology (Licence: SC 83765) | |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2024-10-03 |