| NPI | 1902806284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 48710) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 048710) |
| 207YS0012X Otolaryngology, Sleep Medicine (Licence: GA 48710) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2015-04-23 |