| NPI | 1427037282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: MI SK010029) |
| Additional Taxonomies | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MI SK010029) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2019-02-06 |