| NPI | 1932191608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: TX G0753) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX G0753) |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: TX G0753) | |
| 207YS0012X (Licence: TX G0753) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: TX G0753) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2013-01-17 |