| NPI | 1497794259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MS 10751) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TN 41094) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-05-30 |