| NPI | 1225295868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 253652) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A107722) |
| 207Y00000X Otolaryngology (Licence: CA A107722) | |
| 207Y00000X Otolaryngology (Licence: NY 253652) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2014-05-12 |