| NPI | 1730265612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX M4701) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX M4701) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX M4701) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2026-04-10 |