| NPI | 1528019429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: ND 4554) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MN 29238) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2011-11-30 |