| NPI | 1235219916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 313887) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: VA 101236483) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2009-07-09 |