| NPI | 1124117486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: NC 2010-02022) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A112455) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: SC MD 28074) | |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX P3373) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-10-15 |