| NPI | 1881873271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 62373) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: GA 062373) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2013-04-29 |