| NPI | 1871541227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: UT 1633541205) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: UT 163354-1205) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-10-06 |