| NPI | 1700887767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA MD417702) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MD417702) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2008-04-23 |