| NPI | 1346458247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MN 51678) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MT184361) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-09-19 |