| NPI | 1497783393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MD D0041107) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0041107) |
| 207Y00000X Otolaryngology (Licence: MD D0041107) | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: MD D0041107) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2022-10-10 |