| NPI | 1255336616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 032800) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 032800) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2013-05-13 |