| NPI | 1780626804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 010024) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 0100024) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2016-05-03 |