| NPI | 1306885165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 32368) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CO 32368) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2013-10-01 |