| NPI | 1558321380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO R5C10) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 19023) |
| 207Y00000X Otolaryngology (Licence: KS 04-21322) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2012-03-28 |