| NPI | 1700943990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 16624) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CT 16624) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |