| NPI | 1316505159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: IA MD.MD.61654613) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IA MD.MD.61654613) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IA MD.MD.61654613) | |
| 208600000X Surgery (Licence: IA MD.MD.61654613) | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2025-08-13 |