| NPI | 1366504342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL ME86870) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IN 01026607A) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-07-08 |