| NPI | 1427053370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD425419) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PA MD425419) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: PA MD425419) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PA MD425419) | |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: PA md425419) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2023-03-07 |