| NPI | 1295950376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IA MD-42630) |
| Additional Taxonomies | 174400000X Specialist (Licence: KS PENDING) |
| 207Y00000X Otolaryngology (Licence: IA MD-42630) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2023-10-30 |