| NPI | 1134297484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 200783) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: NY 200783) |
| 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: NY 200783) | |
| 207Y00000X Otolaryngology (Licence: NY 200783) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2025-07-31 |