| NPI | 1285661587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX G5874) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 61523) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2018-03-17 |