| NPI | 1851556302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301091578) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301091578) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-09-11 |