| NPI | 1205903077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX M8988) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 0101241809) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A91455) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2013-11-07 |