| NPI | 1740458397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: OH 35.093756) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 060486) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2014-01-21 |