| NPI | 1134285091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: CA A117324) |
| Additional Taxonomies | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: NY 259357) |
| 207Y00000X Otolaryngology (Licence: PA MD437508) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-10-15 |