| NPI | 1154508638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VT 0420012186) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 6825185-1205) |
| Enumeration Date | 2008-01-27 |
| Last Update Date | 2011-07-07 |