| NPI | 1194928069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: PA md432200) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: PA MD 432200) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: PA md432200) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2019-04-16 |