| NPI | 1679688113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 13598) |
| Additional Taxonomies | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: MS 13598) |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: MS 13598) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2010-06-24 |