| NPI | 1871804971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX Q6749) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: CA A118750) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2016-07-11 |