| NPI | 1861699043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: AL 30592) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MS T1996) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2011-05-04 |