| NPI | 1437222460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR 11793) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WA MD00034647) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-11 |