| NPI | 1730381310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX P0970) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA 201403) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2012-09-27 |