| NPI | 1174839864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR E-11782) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL MFC1664) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2019-02-05 |