| NPI | 1386638286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: AR E1362) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: MO 110242) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TX K6995) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2013-10-09 |