| NPI | 1982785937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: FL 102833) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: LA MD.025820) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2014-09-10 |