| NPI | 1518901875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD.016255) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 16255) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-10-24 |