| NPI | 1063463669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 22488) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 46200) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2016-09-15 |