| NPI | 1780773275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: KY 42511) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: SC LL27208) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-02-21 |