| NPI | 1649273772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA 22390) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 30070) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2009-09-02 |