| NPI | 1063632974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX N3609) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX N3609) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX N3609) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX N3609) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2021-12-02 |