| NPI | 1073521035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI DS043124) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MI 043124) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2007-07-08 |