| NPI | 1922216084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: AR E-7894) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: LA MD.205264) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2023-01-12 |