| NPI | 1306849443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 131422) |
| Additional Taxonomies | 174400000X Specialist (Licence: WI 31422) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2017-03-10 |