| NPI | 1467443515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OR MD167147) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 28198) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2018-07-24 |