| NPI | 1750590238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA 37840) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA R7138) |
| 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: IA 37840) | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: IA 37840) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2011-02-07 |