| NPI | 1568415636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 12886) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 23936) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2015-05-26 |