| NPI | 1659807972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology (Licence: LA 324894) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: LA 324894) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2020-11-03 |