| NPI | 1447719760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD61482391) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WA MD61482391) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WA MD61482391) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD61482391) | |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2024-06-14 |