| NPI | 1598926933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MO 2014024078) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KS 04-37432) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2014-08-21 |