| NPI | 1407028459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: WI 60945) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.012247) |
| 207Y00000X Otolaryngology (Licence: CA A121073) | |
| 207Y00000X Otolaryngology (Licence: WI 60945) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2017-11-03 |