| NPI | 1386636918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 016361) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN md0000041519) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2016-12-02 |