| NPI | 1588154975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NE 35644) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NE 35644) |
| 2086X0206X Surgery, Surgical Oncology (Licence: NE 35644) | |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2024-01-30 |