| NPI | 1083874853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA 38808) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT186055) |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2010-07-20 |