| NPI | 1194949842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WA MD00011220) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00011220) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2013-09-17 |