| NPI | 1689736522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G72491) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G72491) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2013-09-10 |