| NPI | 1790288280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A186385) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CA A186385) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A186385) | |
| 208D00000X General Practice (Licence: NE 32149) | |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2023-07-12 |