| NPI | 1477528859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G89355) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL ME40127) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2014-12-23 |