| NPI | 1649245838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 59006) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00030575) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WA MD00030575) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: WA MD00030575) | |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD00030575) | |
| 208600000X Surgery (Licence: WA MD00030575) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WA MD00030575) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: WA MD00030575) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2019-05-24 |