| NPI | 1992106355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA MD-50061) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 5703) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: UT 12256615-1205) | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: IA MD-50061) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: UT 12256615-1205) | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2022-07-12 |