| NPI | 1639374572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NE 26955) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: IA 41280) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2014-02-14 |