| NPI | 1376535708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C135134) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301063104) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2015-06-26 |