| NPI | 1568531390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX G4870) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OK 14744) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2009-03-18 |