| NPI | 1972506772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: LA MD.008637) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 008637) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2011-11-16 |