| NPI | 1972727063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PR 24174) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A122136) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A122136) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2025-05-19 |