| NPI | 1295995355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 2013-00628) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NY 254119) |
| 207Y00000X Otolaryngology (Licence: GA 067706) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2013-07-19 |