| NPI | 1992758114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: IA 35656) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: WI 47103) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2011-01-12 |