| NPI | 1245239094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 43827) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 043827) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2017-02-01 |