| NPI | 1568443240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: WI 33184) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301051920) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2016-03-18 |