| NPI | 1053434910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N1703) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2006001519) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2014-02-12 |