| NPI | 1437129186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD00011699) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WA MD00011699) |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WA MD00011699) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD00011699) | |
| 208200000X Plastic Surgery (Licence: WA MD00011699) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WA MD00011699) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2021-11-02 |