| NPI | 1841415049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.088221) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: OH 35088221) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2021-03-04 |