| NPI | 1942398847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CA C41977) |
| Additional Taxonomies | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: CA C41977) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2018-03-17 |