| NPI | 1629134739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IN 01034016) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: IN 01034016) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: KY 23772) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: KY 23772) | |
| Enumeration Date | 2006-12-31 |
| Last Update Date | 2008-06-17 |