| NPI | 1881774982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 14029) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 014029) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-01-11 |