| NPI | 1578522959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: UT 172807-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 172807-1205) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2007-07-08 |