| NPI | 1134230436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: PA MD431700) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A75246) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: PA MD431700) | |
| 207Y00000X Otolaryngology (Licence: PA MD431700) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-07-06 |