| NPI | 1043308448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 25829) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 060840) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-01-27 |