| NPI | 1063417012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 28948) |
| Additional Taxonomies | 207YS0012X Otolaryngology Sleep Medicine (Licence: MN 28948) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2012-09-25 |