| NPI | 1619083854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX H0084) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: TX H0084) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX H0084) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2011-09-16 |