| NPI | 1215060413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 7701535-8017) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A063250) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2011-09-22 |