| NPI | 1366438426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2000172900) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2000-172900) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2014-02-07 |