| NPI | 1811936925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: HI MD11100) |
| Additional Taxonomies | 207YP0228X Otolaryngology Pediatric Otolaryngology (Licence: HI MD11100) |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: HI MD11100) | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: HI MD11100) | |
| 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: HI MD11100) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-07-08 |