| NPI | 1457488827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35-090404) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 35-090404) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: OH 35-090404) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2014-12-12 |