NPI | 1649225749 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: CO 35707) |
Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CO 35707) |
Enumeration Date | 2006-05-24 |
Last Update Date | 2012-06-27 |