| NPI | 1285608430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101233287) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX M8555) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2011-03-18 |