| NPI | 1376514521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 9400044) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NC 9400044) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NC 94-00044) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2023-10-12 |