| NPI | 1669680328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MD D0068013) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX P8515) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2015-07-22 |