| NPI | 1205147659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA 20A18178) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WA OP60519665) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MI 5101018567) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2024-05-22 |