| NPI | 1336256601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: AL 00007793) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AL 00007793) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2011-03-25 |