| NPI | 1386833069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA a93414) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA a93414) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA a93414) | |
| 208200000X Plastic Surgery (Licence: CA a93414) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA a93414) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2022-12-05 |