| NPI | 1992723183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: SC ME138195) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC ME138195) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: SC ME138195) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-02-09 |