| NPI | 1013938406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX E3259) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OK 10309) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-07-16 |