| NPI | 1912996422 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 044863)  | 
| Additional Taxonomies | 207YS0012X Otolaryngology, Sleep Medicine (Licence: GA 044863)  | 
| Enumeration Date | 2005-10-18 | 
| Last Update Date | 2014-10-07 |