NPI | 1063565075 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NM MD2012-0882) |
Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: WA MD00016472) |
207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: SD 8123) | |
207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NM MD2012-0882) | |
Enumeration Date | 2007-01-21 |
Last Update Date | 2013-05-13 |