| NPI | 1215932397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 38419) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AR E4088) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2011-09-22 |