| NPI | 1346233467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C153807) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 33726) |
| 207Y00000X Otolaryngology (Licence: MI 4301063970) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2018-07-20 |