| NPI | 1356339063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 011511) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 025947) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2012-12-10 |