| NPI | 1295933984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2011005778) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MO 2005019616) |
| 207Y00000X Otolaryngology (Licence: IA 4053) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2011-09-20 |