| NPI | 1124073606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX M5983) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 232330) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2014-05-01 |