| NPI | 1528232568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX P1492) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 141729) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2013-02-11 |