| NPI | 1295706752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD 00013171) |
| Additional Taxonomies | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: WA MD00013171) |
| 208600000X Surgery (Licence: WA MD00013171) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WA MD00013171) | |
| 2086X0206X Surgery Surgical Oncology (Licence: WA MD00013171) | |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: WA MD00013171) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: WA MD00013171) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: WA MD00013171) | |
| 208200000X Plastic Surgery (Licence: WA MD00013171) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2021-10-27 |