| NPI | 1184932782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine (Licence: AZ 005284) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: AZ 005284) |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2016-04-08 |