| NPI | 1437290004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 57545) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: GA 57545) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: GA 57545) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2008-03-18 |