| NPI | 1386897346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC 35517) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY n/a) |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2013-11-14 |