| NPI | 1750790663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MA 265787) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MA 265787) |
| 207Y00000X Otolaryngology (Licence: MA 265787) | |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2024-10-02 |