| NPI | 1154358117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD420668) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: PA MD420668) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PA MD420668) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-03-24 |