| NPI | 1386815041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: PA os012687) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA 20a9828) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-03-20 |