| NPI | 1104915339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301061976) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: MI 4301061976) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2019-04-18 |