| NPI | 1891956421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO 48097) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: AZ 40924) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2015-05-06 |