| NPI | 1386609220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: GA 12542) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD444495) |
| 208200000X Plastic Surgery (Licence: KY 37961) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: KY 37961) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2023-12-14 |