| NPI | 1528006707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN MD0000010621) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TN MD0000010621) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: TN MD0000010621) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-08 |