| NPI | 1578580205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 23030) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CT 042319) |
| 207YX0901X Otolaryngology, Otology & Neurotology (Licence: OK 23030) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: OK 23030) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-03-14 |