| NPI | 1043223514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: WA MD00048531) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: WA MD00048531) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2017-02-20 |