| NPI | 1710366018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MD D0091646) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MD D0091646) |
| 207Y00000X Otolaryngology (Licence: NE 7401) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MD D0091646) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2022-10-10 |