| NPI | 1780902536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A119458) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CA A119458) |
| 207YS0012X (Licence: CA A119458) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A119458) | |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2017-04-09 |