| NPI | 1144683418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A201296) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A201296) |
| 207Y00000X Otolaryngology (Licence: CA A201296) | |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2026-05-29 |