| NPI | 1194945972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 57165) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2011002617) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2013-01-31 |