| NPI | 1861571960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: AZ 3065) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AZ 3065) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |