| NPI | 1114065893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: UT 157681-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 157681-1205) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-09-25 |