| NPI | 1922236959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA 114190) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA 174400000X - Special) |
| 207Y00000X Otolaryngology (Licence: OR MD165381) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2015-09-08 |