| NPI | 1598854978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA A115578) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL TRN10472) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2016-12-14 |