| NPI | 1821075391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AZ 48133) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: TX H7751) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2014-02-04 |