| NPI | 1659587194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NE 25747) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NE 25747) |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NE 25747) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2013-12-13 |