| NPI | 1366534851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 77529) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 77529) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2017-09-13 |