NPI | 1366676942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA 135518) |
Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: AZ 43416) |
207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 275033) | |
Enumeration Date | 2009-05-11 |
Last Update Date | 2023-04-26 |