| NPI | 1306846407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2005041177) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC 15294) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2018-12-27 |