| NPI | 1003871971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101043630) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: VA 010143630) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: VA 0101043630) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: VA 0101043630) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2008-06-06 |