| NPI | 1225063548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: FL ME54913) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME54913) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2009-04-28 |