| NPI | 1881692317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: KY 29592) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01041529B) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2017-01-12 |