| NPI | 1659520906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX P2101) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IN 01069139A) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: IL 125.051605) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2012-07-27 |