| NPI | 1306849500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TN 39354) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TN 39354) |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: TN 39354) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2014-11-05 |