| NPI | 1265511406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX E1913) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SD 4049) |
| 208200000X Plastic Surgery (Licence: SD 4049) | |
| 208200000X Plastic Surgery (Licence: TX E1913) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |