| NPI | 1922323443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TX Q7457) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2026000702) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2026-03-13 |