| NPI | 1992760144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MI 4301050068) |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology (Licence: MI 4301050068) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-03-29 |