| NPI | 1376561142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 030190) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 25083) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2016-05-03 |