| NPI | 1275681686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 188579-1205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WY 5395A) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2017-04-05 |