NPI | 1285908509 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: TN 64361) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 64361) |
207YS0123X Otolaryngology Facial Plastic Surgery (Licence: TN PENDING) | |
2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IA T1125) | |
Enumeration Date | 2012-03-05 |
Last Update Date | 2023-03-07 |