| NPI | 1326019621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 14930) |
| Additional Taxonomies | 174400000X Specialist (Licence: MN 43263) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2018-06-27 |