| NPI | 1487651303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IA 31968) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IA 31968) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: IA 31968) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2014-03-11 |