| NPI | 1427050228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: VA 0101251514) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NC 00-39310) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2014-08-18 |