| NPI | 1255358842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO R5161) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MO R5161) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-01-09 |