| NPI | 1073641684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NY 108967) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 108767) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2008-10-02 |