| NPI | 1598754871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX K8361) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AR C7724) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2015-06-04 |