| NPI | 1457394611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AR N7584) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN MD0000016200) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2012-10-01 |