| NPI | 1629134929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 18587) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: NE 18587) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2013-02-13 |