| NPI | 1619179538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SD 8045) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 37248) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2013-06-21 |