| NPI | 1639485246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: ID O-0778) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2010019812) |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: MO 2010019812) | |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2014-04-01 |