| NPI | 1366469686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 033849) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 033849) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2011-09-27 |