| NPI | 1265479000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: SC 29469) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA G85176) |
| 207Y00000X Otolaryngology (Licence: GA 58966) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2016-03-15 |