| NPI | 1710946157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA G77382) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 75290) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2009-09-16 |