| NPI | 1578783395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CO 50123) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CO DR50123) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA A116958) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CO 50123) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2024-12-03 |