| NPI | 1245386051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G25063) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G25063) |
| 2086X0206X Surgery, Surgical Oncology (Licence: CA G25063) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |