| NPI | 1235450958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: MA 262971) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 39) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2015-10-13 |