| NPI | 1700026036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: VA 0101269500) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: FL ME115959) |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: MD D0095977) | |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2023-06-13 |