| NPI | 1578547626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OK 24747) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PR 09244) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2014-07-22 |