| NPI | 1689720468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: OR MD27979) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: AZ 42031) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-02-02 |