| NPI | 1316109978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME121042) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME121042) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL ME121042) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL ME121042) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME121042) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-09-14 |