| NPI | 1871708636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2011-00350) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA A111984) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2011-07-28 |