| NPI | 1457371841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35-053219) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH 35.053219) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-09-26 |