| NPI | 1942465489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 253987) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MA 237458) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2014-07-02 |