| NPI | 1154559672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 23716) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 003555) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2016-11-17 |