| NPI | 1437379377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: AL 30949) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 5522) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-01-25 |