| NPI | 1295898179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2008033152) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KS 9406666) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2015-10-15 |