| NPI | 1942437140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: SD 9230) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: MI 5101018298) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2014-07-16 |