| NPI | 1922461391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NY 317752) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 317752) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 317752) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2023-07-31 |