NPI | 1427107150 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: SC 7485) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: SC 7485) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2007-07-08 |