| NPI | 1346290798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101043687) |
| Additional Taxonomies | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: VA 0101043687) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2009-12-07 |