| NPI | 1194011437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 78238) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN19436) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2018-03-17 |