| NPI | 1194832592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA ML20007367) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 235115) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2015-02-19 |