| NPI | 1477519833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 93362) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: GA 93362) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-11-15 |