| NPI | 1013980002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 1621) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 5101011938) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2013-01-15 |