| NPI | 1467410613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD00034623) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD00034623) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WA MD00034623) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-05-15 |