| NPI | 1720134307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 51170) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: OR 153458) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2013-08-12 |