| NPI | 1043378409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: CA G13883) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G13883) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2010-03-01 |