| NPI | 1043268956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: PR 9966) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: PR 9966) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2014-05-20 |