| NPI | 1023082203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD00019697) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WA MD00019697) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WA MD00019697) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD00019697) | |
| 208200000X Plastic Surgery (Licence: WA MD00019697) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: WA MD00019697) | |
| 208600000X Surgery (Licence: WA MD00019697) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WA MD00019697) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: WA MD00019697) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-10-27 |