| NPI | 1902833452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD417924) | 
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX M1858) | 
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PA MD417924) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX M1858) | |
| Enumeration Date | 2006-06-27 | 
| Last Update Date | 2025-08-29 |