| NPI | 1265435697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR R-3860) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR R3860) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2019-09-20 |