| NPI | 1780718791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TN 42023) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A84366) |
| 207Y00000X Otolaryngology (Licence: TX M8817) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-11-25 |