NPI | 1619966686 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: TX N3480) |
Additional Taxonomies | 207YS0012X Otolaryngology Sleep Medicine (Licence: CA A95717) |
207YS0012X Otolaryngology Sleep Medicine (Licence: TX N3480) | |
207YS0123X Otolaryngology Facial Plastic Surgery (Licence: CA A95717) | |
207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: CO 39421) | |
2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TX N3480) | |
Enumeration Date | 2005-10-20 |
Last Update Date | 2020-02-19 |