| NPI | 1336212679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX E3557) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX E3557) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2009-12-21 |