| NPI | 1548463839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL ME113636) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL ME113636) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME113636) | |
| 207Y00000X Otolaryngology (Licence: FL ME113636) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL ME113636) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2025-03-26 |