| NPI | 1245449701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA MD-48659) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: IA MD-48659) |
| 207YS0012X (Licence: IA MD-48659) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IA MD-48659) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: IA MD-48659) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IA MD-48659) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: KS 0435020) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IA MD-48659) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2021-08-09 |