| NPI | 1407838527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 17993) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 17993) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2008-01-22 |