| NPI | 1558582668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX N9821) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS T1930) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2011-07-08 |