| NPI | 1316505159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: IA MD-53176) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA MD-53176) |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: IA MD-53176) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: IA MD-53176) | |
| 208600000X Surgery (Licence: IA MD-53176) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2024-08-08 |