| NPI | 1013907526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 26752) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 23635) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2010-06-10 |