| NPI | 1164576534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 019151) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 019151) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: GA 019151) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2015-09-22 |