| NPI | 1205982931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: FL OS7773) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: FL OS7773) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2016-07-26 |