| NPI | 1205825031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MO MD R2G99) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MO MD R2G99) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2017-06-19 |