| NPI | 1669738324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301111630) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MI 4301111630) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MI 4301111630) | |
| Enumeration Date | 2012-04-07 |
| Last Update Date | 2024-01-16 |