| NPI | 1578528055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NE 17965) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 17965) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2018-01-22 |