| NPI | 1164624763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MD D67391) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: IN 01063072A) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2008-07-24 |