| NPI | 1639159007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI FB009336) |
| Additional Taxonomies | 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: MI FB009336) |
| 208200000X Plastic Surgery (Licence: MI FB009336) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2008-05-16 |