| NPI | 1831148352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NM 90296) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CO 44598) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2010-03-26 |