| NPI | 1457479297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WI 52034-20) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 52034) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: WI 52034) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: WI 52034-20) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2019-12-02 |