| NPI | 1942595814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: CO DR.0056678) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: NE 6576) |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2017-02-06 |