| NPI | 1225051279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.133855) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: OH 35.133855) |
| 207Y00000X Otolaryngology (Licence: LA 204958) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: OH 35.133855) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: MO 2007018704) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-04-28 |