| NPI | 1689730749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD.026028) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 131339) |
| Enumeration Date | 2006-12-30 |
| Last Update Date | 2014-01-17 |