| NPI | 1144433962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA 37927) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OH 57.006148) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-09-17 |