| NPI | 1710088026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA 231557) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 231557) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2007-08-11 |