| NPI | 1477640357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX K2989) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NM 2003-0093) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2008-05-22 |