| NPI | 1760477723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 49517) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: KY 45832) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2015-06-23 |