| NPI | 1942368394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G37043) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G37043) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G37043) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |