| NPI | 1942469523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: CA A37144) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A37144) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |