| NPI | 1811937048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: FL OS16264) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NJ 25MB06532600) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MB06532600) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MB06532600) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2021-02-17 |