| NPI | 1962463968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 08321) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MS 08321) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MS 08321) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-08-11 |