| NPI | 1073559936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL OS 10422) |
| Additional Taxonomies | 207YS0012X (Licence: FL OS10422) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: FL os10422) | |
| 208200000X Plastic Surgery (Licence: FL OS 10422) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2021-09-10 |