| NPI | 1942278908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 250315) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NC 2007-00057) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2015-02-23 |