| NPI | 1023017167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: SD 7612) |
| Additional Taxonomies | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: OH 34007897) |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: MI 5101013470) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2012-05-18 |