| NPI | 1326045048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 52260) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA 14873R) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-11-02 |