| NPI | 1952765943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0069525) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: UT 13279289-1205) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2024-07-26 |