| NPI | 1831186840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CT 041543) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 217650) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2010-10-21 |