| NPI | 1366434086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 22771-020) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WI 222771) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2009-10-30 |