| NPI | 1932380664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: SC LL30305) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY P54781) |
| Enumeration Date | 2007-11-22 |
| Last Update Date | 2007-11-22 |