| 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 |