| NPI | 1457302622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 11581) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 1696) |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2018-04-20 |