| NPI | 1780070417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NC 2024-01202) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX S9911) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: SC 92136) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2024-12-16 |